Torn ligaments. Pulled
muscles. Overuse injuries. With every new exercise routine comes a new risk of
injury, whether it is straining a muscle from lifting, developing knee pain
from running or tearing a tendon during calisthenics. With an estimated 8.6
million sports and recreation-related injuries each year in America, these
fears are not unfounded.
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However, before you let this fear keep you
from starting an exercise routine, the good news is that the majority of sports
injuries are “overuse-related, rather than traumatic, meaning they typically
don’t require surgery,” said Dr Matthew Matava, an orthopedic surgeon and sports
medicine physician at
Washington University in St. Louis.
With the right precautions, you can develop a
well-rounded exercise routine, one that maximizes the benefits while minimizing
the risk of injury. To get a sense of the exercises that leave you especially
vulnerable to injury, we turned to a mixture of sports doctors,
physical therapists and athletic trainers to get their consensus on the most common
mistakes people are making, and how to prevent them.
Do not round the back
for deadlifting
The deadlift
— where a lifter starts in a squatting position, pulling a weighted bar up into
an upright, locked position — is one of the most common lifts. However, its
simplicity is deceiving. “Deadlift is one of the best tools, if done correctly,
and one of the most dangerous things you can do if done wrong,” said Cameron
Apt, an athletic trainer at the University of Rochester.
One of the major mistakes people make is
rounding — or hunching — the back. The deadlift starts with the lifter in a
squatting position, with a neutral spine, meaning the back is neither
overarched nor rounded, from which they pull the weight up to their thigh.
During this movement, even a slight rounding of the spine can put excess
pressure on the muscles of the lower back, potentially throwing out the back or
worse.
“It’s not even necessarily that people have
bad form, it’s that people underestimate how much of a dynamic and
hyper-focused exercise deadlifting is,” said
Femi Betiku, a physical therapist
at the New Jersey Center of Physical Therapy Riverdale. “They’re not paying
attention for a split second, and then their back rounds a little bit, and then
‘Boom!’”
For those who are less experienced, there are
a number of alternative exercises that can offer similar benefits and put less
strain on the lower back. This includes hex bar deadlifts, in which the wide
hexagonal-shaped bar, which surrounds the lifter, reduces the amount of
pressure on the lower back.
Use proper bench-press
form
When
most people think of weightlifting, the first thing they might think of is the
bench press, where a lifter lies on a bench, pressing the weight upward. The
bench press is so familiar that comedians from Chris Farley to YouTube star
Mike Tornabene have used it to poke fun at bodybuilders. But it can cause
rotator cuff injuries if done incorrectly.
The rotator cuff is especially vulnerable
because so many tendons, ligaments, blood vessels and nerves travel through a
tight path, called the sub-acromial space, between the shoulder blade and
humerus. “It’s this very small little space that is almost like a roadway,”
said Lauren Shroyer, an athletic trainer with the American Council on Exercise,
who specializes in chronic injuries.
A common mistake is hunching the shoulders upward, almost like
slouching in a chair, which can put a huge amount of strain on this area.
Shroyer said this could lead to impingement syndrome, a painful condition
caused by the shoulder blade rubbing against the rotator cuff. The same can
also happen if you raise the bar over your head, rather than your chest. To
avoid this, she said, make sure that your arms are shoulder-width apart, the
shoulder blades pinched together, with the bar being lowered to the middle of
the chest.
Another common issue is lifting too much too
quickly, which can lead to an acute injury, such as tearing the pectoral
muscle. When this happens, the lifter will often feel a popping sensation, lose
control of the weight, and now “one nipple is pointing one way and the other
nipple is pointing the other way,” Matava said. “We’ll see that a lot,” he
added, often in inexperienced lifters who try to lift more weight than they are
ready for.
Be mindful about running
frequency
In his
own clinical practice, Matava treats injuries from weightlifting and running
most often. “Of the two, I probably see running the most,” he said. The bulk of
these injuries are overuse related. “For running, it’s the rule of too’s,”
Matava said. “Too many miles, too many hills, too little rest.”
One common issue in runners is knee pain,
specifically patellofemoral pain syndrome, often called “runner’s knee.”
Runner’s knee is thought to be nerve irritation caused by a muscle imbalance
between the quadriceps, hamstrings and hip muscles that skews the kneecap. To
prevent it, build up your mileage gradually and incorporate regular strength
training. The good news is that although runner’s knee is an issue, research
shows that running may serve to strengthen the cartilage of the knees, with
runners less likely to develop arthritis than their non-running peers.
Another common overuse injury among runners
is stress fractures. This often happens when a runner tries to add too many
kilometers too quickly, without taking enough rest days. The impact of running
causes microfractures in the bone, which, when given time to heal, lead to
stronger bones. However, if a runner starts running more miles, without taking
rest days, these microfractures build up to the point of injury.
Both of these injuries tend to happen because
runners “did something out of the ordinary compared to what they were trained
to do,” Matava said. Typically, he will see such stress fractures in people who
just started running, or who decided to quickly ramp up training. A good rule
of thumb is to limit distance increases to less than 10 percent a week.
Use caution in dynamic movements
One of
the most common acute, sports-related injuries is a meniscus tear, which at
least 10 percent of people will experience during their lifetime. The menisci
are discs of cartilage that act as shock absorbers, located on the ends of the
thighbone and shinbone. Most tears are caused by degeneration of the cartilage,
which makes it more susceptible to injury, and can happen during squatting or
twisting motions, such as box jumps or weighted squats, or while playing
tennis, soccer or basketball.
Meniscus tears often happen during dynamic
movements. The risk of injury increases when these movements are performed too
fast, with too many pounds or without having practiced the movement enough. For
example, with squats, if a person has “too much weight, and they go down too
deep, the meniscus can tear,” Matava said.
As with other injuries, the risk increases toward the end
of a workout, when fatigue starts to set in. Shroyer learned this lesson the
hard way when she pushed herself too hard powerlifting. “I was getting tired,
but I told myself, ‘You can do another set,’” she said. Instead, she tore the
cartilage at the end of her femur, an injury that required surgery and six
weeks of immobilization.
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